To the Editor:

I read with interest the recent article, "Coronary Artery Disease in Women: The Myth Still Exists."1 The statistics about this disease as it relates to women are frightening. It is dismaying to know that in this day and age, symptoms in women still often go unrecognized as much as they do.

Your research gives testament to what my diabetic mother (age, 82 years) experienced 2 years ago. She was living in a nursing home, and I was visiting her frequently. On one visit, I was shocked to find her in a wheelchair, with poor color, muscle tone, and decreased mental status. She had been fine during a visit 2 weeks earlier. When I questioned the nurses, they said that although Mom had not felt like walking lately, she had said her health was fine! A larger hospital found that she had experienced a massive myocardial infarction 10 to 12 days earlier. Later at a care conference, her nurses said that they couldn't really be expected to recognize the myocardial infarction because my mother had atypical symptoms. Although her physician apologized that he missed the diagnosis, my mother was the one who paid the price. Because she went without treatment, 90% of her heart is gone, and her ejection fraction is 15%. She doesn't have much energy, but she does as well as she can.

While doing your research, did you discover any assessment tools which could help nurses recognize disease symptoms? Nurses always rushed; it is sometimes difficult to take the extra time to assess for possible heart disease when we interact with our clients. It is just something that we should incorporate into our mindset and find a way to do, whatever our job setting. The consequences are just too awful if we don't. Your article should be required reading for all of us in the nursing profession, and probably for some medical professionals as well. Thank you for writing it.

Beth Grund, RN

Bloomington, MN

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